Download MBBS Anatomy PPT 19 Scapular And Back Region Notes

Muscles Connecting the Upper

--- Content provided by FirstRanker.com ---

Limb to the Vertebral Column

Movements of Scapula

Movements of Scapula

--- Content provided by FirstRanker.com ---

Movements of Scapula

Movements of Scapula

--- Content provided by FirstRanker.com ---

Arranged in two layers

Layer 1st

--- Content provided by FirstRanker.com ---

a. Trapezus

b. Latissimus dorsi

Layer 2nd

--- Content provided by FirstRanker.com ---

a. Levator scapulae

b. Rhomboideus major

--- Content provided by FirstRanker.com ---

and minor

--- Content provided by FirstRanker.com ---

Trapezius

Origin

? Occipital bone(external occiptal

--- Content provided by FirstRanker.com ---

protuberunce), superior nuchal

line, ligamentum nuchae, spine of

--- Content provided by FirstRanker.com ---

seventh cervical vertebra, spines

of all thoracic vertebrae and their

supraspinous ligament

--- Content provided by FirstRanker.com ---

Insertion

? Upper fibers into posterior border

--- Content provided by FirstRanker.com ---

of lateral third of clavicle

? middle fibres- medial border of

acromion and upper lip of crest of

--- Content provided by FirstRanker.com ---

spine

? lower fibers pass upward and

--- Content provided by FirstRanker.com ---

laterally and insert on medial end

of spine of scapula

Trapezius

--- Content provided by FirstRanker.com ---

Nerve Supply

? Spinal part of accessory nerve

--- Content provided by FirstRanker.com ---

(motor) and ventral rami of C3

and 4 (sensory- proprioceptive)

Action

--- Content provided by FirstRanker.com ---

? Upper fibers along with levator

scapulae elevate the scapula;

--- Content provided by FirstRanker.com ---

? middle fibers with rhomboids

pull scapula medially (retracts);

? lower fibers pull medial border of

--- Content provided by FirstRanker.com ---

scapula downward , so upper and

lower fibres acting together

--- Content provided by FirstRanker.com ---

rotate scapula-glenoid cavity face

upward assisted by lower 5

digitations of serratus anterior

--- Content provided by FirstRanker.com ---

Latissimus dorsi

Origin

--- Content provided by FirstRanker.com ---

? Iliac crest, lumbar fascia, spines of

lower six thoracic vertebrae(T7-

T12), lower three or four ribs, and

--- Content provided by FirstRanker.com ---

inferior angle of scapula (5)

Insertion

--- Content provided by FirstRanker.com ---

? Floor of bicipital groove of

humerus (1)

Nerve Supply

--- Content provided by FirstRanker.com ---

? Thoracodorsal nerve

? C6, 7, 8,

--- Content provided by FirstRanker.com ---

Action

? Extends, adducts, and medially

rotates the arm (3)

--- Content provided by FirstRanker.com ---

? Its called the climbing muscle

? Raising of the trunk above the arm

--- Content provided by FirstRanker.com ---

Levator scapulae

Origin

? Transverse processes of first fourth cervical

--- Content provided by FirstRanker.com ---

vertebrae (1)

Insertion

--- Content provided by FirstRanker.com ---

? Medial border of scapula (1)

Nerve supply

? C3 and 4 and dorsal scapular nerve

--- Content provided by FirstRanker.com ---

? C3, 4, 5

Action

--- Content provided by FirstRanker.com ---

? Raises medial border of scapula


ligamentum nuchae

--- Content provided by FirstRanker.com ---

The ligamentum nuchae is a

large median ligament

composed of tendons and

--- Content provided by FirstRanker.com ---

fascia located between the

posterior muscles of the

--- Content provided by FirstRanker.com ---

neck. It covers the spines of

C1 to C6 vertebrae. It is a

superior and posterior

--- Content provided by FirstRanker.com ---

extension of the

supraspinous ligamen

--- Content provided by FirstRanker.com ---

Rhomboid minor

Origin

? Ligamentum nuchae and

--- Content provided by FirstRanker.com ---

spines of seventh cervical

and first thoracic vertebrae

--- Content provided by FirstRanker.com ---

(3)

Insertion

? Medial border of scapula (1)

--- Content provided by FirstRanker.com ---

Nerve supply

? Dorsal scapular nerve C4, 5

--- Content provided by FirstRanker.com ---

Rhomboid major

Origin
? Second to fifth thoracic spines
Insertion

--- Content provided by FirstRanker.com ---

? Medial border of scapula (1)

Nerve supply
? Dorsal scapular nerve C4, 5

--- Content provided by FirstRanker.com ---

Action
? Retract scapula
? The rhomboids work collectively with the

levator scapulae muscles to elevate the

--- Content provided by FirstRanker.com ---

medial border of the scapula, downwardly

rotating the scapula with respect to the

--- Content provided by FirstRanker.com ---

glenohumeral joint.

Muscles Connecting the Scapula

to the Humerus

--- Content provided by FirstRanker.com ---

Deltoid

Origin

--- Content provided by FirstRanker.com ---

? Lateral third of clavicle, acromion, spine of

scapula

--- Content provided by FirstRanker.com ---

Insertion

? Middle of lateral surface of shaft of humerus

Nerve supply

--- Content provided by FirstRanker.com ---

? Axillary nerve C5, 6

Action

--- Content provided by FirstRanker.com ---

? Middle fibers Abducts arm; anterior fibers flex

and medially rotate arm; posterior fibers

extend and laterally rotate arm

--- Content provided by FirstRanker.com ---

? Abduction from 15-90 degrees

Intramuscular Injection

--- Content provided by FirstRanker.com ---

Structures under cover of Deltoid

BONE- Upper part humerus, coracoid process
,greater tubercle, lesser tubercle Intertuberculus

--- Content provided by FirstRanker.com ---

sulcus

Bursa- Subdeltoid , subacromial bursa
Muscles ? attached around shoulder joint

--- Content provided by FirstRanker.com ---

Vessel- Ant and Post circumflex humeral vessel
Nerves- Axillary

Supraspinatus

--- Content provided by FirstRanker.com ---

Origin

? Supraspinous fossa of scapula

Insertion

--- Content provided by FirstRanker.com ---

? Greater tuberosity of

humerus; capsule of shoulder

--- Content provided by FirstRanker.com ---

joint

Nerve supply

? Suprascapular nerve 5, 6

--- Content provided by FirstRanker.com ---

Action

? Abducts arm and stabilizes

--- Content provided by FirstRanker.com ---

shoulder joint

? Initiation of abduction 0-15

degrees

--- Content provided by FirstRanker.com ---

Infraspinatus

Origin

--- Content provided by FirstRanker.com ---

? Infraspinous fossa of scapula

Insertion

? Middle impression of greater

--- Content provided by FirstRanker.com ---

tubercle of humerus; capsule

of shoulder joint

--- Content provided by FirstRanker.com ---

Nerve supply

? Suprascapular nerve after

passing through spino-glenoid

--- Content provided by FirstRanker.com ---

notch 5, 6

Action

--- Content provided by FirstRanker.com ---

? Lateral y rotates arm and

stabilizes shoulder joint

--- Content provided by FirstRanker.com ---

Teres major

Origin

? Lower third of lateral border of

--- Content provided by FirstRanker.com ---

scapula

Insertion

--- Content provided by FirstRanker.com ---

? Medial lip of bicipital groove of

humerus

Nerve supply

--- Content provided by FirstRanker.com ---

? Lower subscapular nerve C6, 7

Action

--- Content provided by FirstRanker.com ---

? Medially rotates and adducts arm

and stabilizes shoulder joint

Teres minor

--- Content provided by FirstRanker.com ---

Origin

? Upper two thirds of lateral border

--- Content provided by FirstRanker.com ---

of scapula

Insertion

? Greater tuberosity of humerus;

--- Content provided by FirstRanker.com ---

capsule of shoulder joint

Nerve supply

--- Content provided by FirstRanker.com ---

? Axillary nerve (C4), C5, 6

Action

? Laterally rotates arm and

--- Content provided by FirstRanker.com ---

stabilizes shoulder joint

Subscapularis

--- Content provided by FirstRanker.com ---

Origin

? Subscapular fossa

Insertion

--- Content provided by FirstRanker.com ---

? Lesser tuberosity of humerus

Nerve supply

--- Content provided by FirstRanker.com ---

? Upper and lower subscapular

nerves C5, 6, 7

Action

--- Content provided by FirstRanker.com ---

? Medially rotates arm and stabilizes

shoulder joint

--- Content provided by FirstRanker.com ---

Rotator Cuff

? The rotator cuff is the name

given to the tendons of the

--- Content provided by FirstRanker.com ---

subscapularis, supraspinatus,

infraspinatus, and teres minor

--- Content provided by FirstRanker.com ---

muscles

? are fused to the underlying

capsule of the shoulder joint

--- Content provided by FirstRanker.com ---

? stabilizing the shoulder joint

? The cuff is deficient inferiorly,

--- Content provided by FirstRanker.com ---

and this is a site of potential

weakness.

--- Content provided by FirstRanker.com ---

Rotator Cuff

--- Content provided by FirstRanker.com ---

Axillary Nerve

? The axil ary nerve arises from the

--- Content provided by FirstRanker.com ---

posterior cord of the brachial

plexus (C5 and 6) in the axil a

--- Content provided by FirstRanker.com ---

? It passes backward and enters

the quadrangular space with the

posterior circumflex humeral

--- Content provided by FirstRanker.com ---

artery

? As the nerve passes through the

--- Content provided by FirstRanker.com ---

space, it comes into close

relationship with the inferior

aspect of the capsule of the

--- Content provided by FirstRanker.com ---

shoulder joint and with the

medial side of the surgical neck

--- Content provided by FirstRanker.com ---

of the humerus

? It terminates by dividing into

anterior and posterior branches

--- Content provided by FirstRanker.com ---

Axillary Nerve

? branches:

--- Content provided by FirstRanker.com ---

? An articular branch to the

shoulder joint

--- Content provided by FirstRanker.com ---

? An anterior terminal

branch, which winds

around the surgical neck

--- Content provided by FirstRanker.com ---

of the humerus beneath

the deltoid muscle; it

--- Content provided by FirstRanker.com ---

supplies the deltoid and

the skin that covers its

lower part.

--- Content provided by FirstRanker.com ---

Axillary Nerve

? A posterior terminal branch, which gives off

--- Content provided by FirstRanker.com ---

a branch to the teres minor muscle and a

few branches to the deltoid, then emerges

from the posterior border of the deltoid as

--- Content provided by FirstRanker.com ---

the upper lateral cutaneous nerve of the

arm

--- Content provided by FirstRanker.com ---

? The axillary nerve can be injured in

dislocations of the shoulder joint

Suprascapular nerve

--- Content provided by FirstRanker.com ---

Arterial Anastomosis Around the

Shoulder Joint

--- Content provided by FirstRanker.com ---

? The extreme mobility of the

shoulder joint may result in

kinking of the axillary artery

--- Content provided by FirstRanker.com ---

and a temporary occlusion

of its lumen

--- Content provided by FirstRanker.com ---

? To compensate for this, an

important arterial

anastomosis exists between

--- Content provided by FirstRanker.com ---

the branches of the

subclavian artery and the

--- Content provided by FirstRanker.com ---

axillary artery

? ensuring that an adequate

blood flow takes place into

--- Content provided by FirstRanker.com ---

the upper limb irrespective

of the position of the arm

--- Content provided by FirstRanker.com ---

Arterial Anastomosis Around the Shoulder Joint

Branches from the Subclavian Artery

--- Content provided by FirstRanker.com ---

? The suprascapular artery, which is

distributed to the supraspinous and

infraspinous fossae of the scapula

--- Content provided by FirstRanker.com ---

? The superficial or transverse cervical

artery, which gives off a deep branch that

--- Content provided by FirstRanker.com ---

runs down the medial border of the

scapula

Branches from the Axil ary Artery

--- Content provided by FirstRanker.com ---

? The subscapular artery and its circumflex

scapular branch supply the subscapular

--- Content provided by FirstRanker.com ---

and infraspinous fossae of the scapula,

respectively.

? The anterior circumflex humeral artery

--- Content provided by FirstRanker.com ---

? The posterior circumflex humeral artery

? Both the circumflex arteries form an

--- Content provided by FirstRanker.com ---

anastomosing circle around the surgical

neck of the humerus

Triangle Of Auscultation

--- Content provided by FirstRanker.com ---

Boundaries-

Below- Horizontal fibres

--- Content provided by FirstRanker.com ---

of latissimus dorsi

Medially- lateral border

of trapezius

--- Content provided by FirstRanker.com ---

Laterally- vertebral

border of scapula

--- Content provided by FirstRanker.com ---

Floor ? 6th and 7th rib

Apex of lower lobe of

both lungs lie beneath

--- Content provided by FirstRanker.com ---

this triangle

Scapular Fracture

--- Content provided by FirstRanker.com ---

Is there any problem ?
MCQ

? Injury to which of the following nerve leads to

--- Content provided by FirstRanker.com ---

winging of scapula

a) Long thoracic nerve
b) Thoracodorsal nerve

--- Content provided by FirstRanker.com ---

c) Suprascapular nerve
d) Dorsal scapular nerve

MCQ

--- Content provided by FirstRanker.com ---

? Which of the following group of muscle acts as

lateral rotator of shoulder joint

a) Teres minor and infraspinatus

--- Content provided by FirstRanker.com ---

b) Teres minor and teres major
c) Supraspinatus and infraspinatus
d) Serratus anterior and rhomboids

MCQ

--- Content provided by FirstRanker.com ---

? Which of the following group of muscle acts as

lateral rotator of shoulder joint

--- Content provided by FirstRanker.com ---

a) Teres minor and infraspinatus
b) Teres minor and teres major
c) Supraspinatus and infraspinatus
d) Serratus anterior and rhomboids